A comparison of ECG-based home monitoring devices in adults with CHD

Pengel, L K D; Robbers‐Visser, Daniëlle; Groenink, Maarten; Winter, Michiel M.; Schuuring, Mark J.; Bouma, Berto J.; Bokma, Jouke P.

doi:10.1017/s1047951122002244

Cited by 7 publications

(11 citation statements)

References 28 publications

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“…With respect to PR intervals, the prior studies have cant bias and a strong correlation for smartwatch ECGs with Pearson's correlation coe cients of 0.78 and 0.93, respectively. (9,10). Our ndings are consistent with that.…”

Section: Interobserver Variabilitysupporting

confidence: 93%

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Validation of smartwatch electrocardiogram intervals in children compared to standard 12 lead electrocardiograms

Ernstsson,

Svensson,

Liuba

et al. 2024

Preprint

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Background/Aim: Lay people are now able to obtain one-lead electrocardiograms (ECG) using smartwatches, which facilitates documentation of arrhythmias. The accuracy of smartwatch derived ECG intervals has not been validated in children though. Home-based monitoring of ECG intervals using a smartwatch could improve monitoring of children, e.g. when taking QTc prolonging medications. The aim of this study was to validate the ECG intervals measured by smartwatch in comparison to standard 12-lead ECGs in children and adolescents. Methods: Prospective study of children (age 5 - 17 years) at the outpatient clinic of a national pediatric heart center. Patients underwent a smartwatch ECG (ScanWatch, Withings) and a simultaneous standard 12-lead ECG. ECG intervals were measured both automatically and manually from the smartwatch ECG and the 12-lead ECG. Intraclass correlation coefficients and Bland-Altman plots were performed. Results: 100 patients (54% male, median age 12.9 (IQR 8.7-15.6) were enrolled. The ICC calculated from the automated smartwatch and automated 12-lead ECG were excellent for heart rate (ICC 0.97, p<0.001), good for the PR and QT intervals (ICC 0.86 and 0.8, p<0.001), and moderate for the QRS duration and QTc interval (ICC 0.7 and 0.53, p<0.001). When using manual measurements for the smartwatch ECG, validity was improved for the PR interval (ICC 0.93, p<0.001), QRS duration (ICC 0.92, p<0.001), QT (ICC 0.95, p<0.001) and QTc interval (ICC 0.84, p<0.001). Conclusion: Automated smartwatch intervals are most reliable measuring the heart rate. The automated smartwatch QTc intervals are less reliable, but this may be improved by manual measurements.

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Section: Interobserver Variabilitysupporting

confidence: 93%

“…To our knowledge, no studies have previously validated the ECG-intervals measured by a smartwatch children or adolescents, but a few have been performed on adults manual measurements of the Withings ScanWatch (9,10). Overall, these studies reported similar ndings as ours.…”

Section: Interobserver Variabilitysupporting

confidence: 81%

Validation of smartwatch electrocardiogram intervals in children compared to standard 12 lead electrocardiograms

Ernstsson,

Svensson,

Liuba

et al. 2024

Preprint

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“…The authors concluded that fair agreement was observed between AI and 12-lead ECGs. Pengel et al ( 27 ) compared different devices for ECG monitoring to the standard 12-lead ECG to examine the accuracy of these devices in adults with congenital heart disease. ECG intervals were manually evaluated for these devices.…”

Section: Resultsmentioning

confidence: 99%

Smart devices to measure and monitor QT intervals

Hoek,

Brouwer,

Voors

et al. 2023

Front. Cardiovasc. Med.

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Careful observation of the QT interval is important to monitor patients with long QT syndrome and during treatment with potentially QT-prolonging medication. It is also crucial in the development of novel drugs, in particular in case of a potential side effect of QT prolongation and in patients with increased risk of QT prolongation. The 12-lead electrocardiogram (ECG) is the gold standard to evaluate cardiac conduction and repolarization times. Smartwatches and smart devices offer possibilities for ambulatory ECG recording and therefore measuring and monitoring the QT interval. We performed a systematic review of studies on smartwatches and smart devices for QTc analysis. We reviewed PubMed for smartwatches and smart devices that can measure and monitor the QT interval. A total of 31 studies were included. The most frequent devices were (1) KardiaMobile 6L, a Food and Drug Administration-approved device for QTc analyses that provides a 6-lead ECG, (2) an Apple Watch, a smartwatch with an integrated ECG tool that allows recording of a single-lead ECG, and (3) the Withings Move ECG ScanWatch, an analog watch with a built-in single-lead ECG. The KardiaMobile 6L device and the Apple Watch provide accurate measurements of the QT interval, although the Apple Watch is studied in standard and non-standard positions, and the accuracy of QT measurements increased when the smartwatch was moved to alternative positions. Most studies were performed on patients, and limited results were available from healthy volunteers.

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“…Our results demonstrate a high device accuracy of smartwatches and other ambulant ECG monitors, such as Zio patch, Eko DUO or KardiaMobile 6L in ACHD patients. [ 16 ] Striepe et al demonstrated that the Apple Watch can record reliable iECGs in patients with congenital heart disease of any type. [ 15 ]…”

Section: Discussionmentioning

confidence: 99%

“…They evaluated 30-s ECGs of ACHD patients acquired by the Withings ScanWatch in L lead. [ 16 ] Of the ECGs acquired by the ScanWatch, 51% were either of good or excellent quality. A total of 70% of the Eko DUO device registrations and 74% of KardiaMobile 6L registrations were of good or excellent quality.…”

Section: Smartwatch-and Smartphone-based Single-lead Ecgmentioning

confidence: 99%

Value of Extended Arrhythmia Screening in Adult Congenital Heart Disease Patients

Koole,

de Jong,

Mulder

et al. 2024

Arrhythm Electrophysiol Rev

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The European Society of Cardiology guidelines for the management of adult congenital heart disease patients recommend screening for arrhythmias and bradycardias in symptomatic patients, often being done by means of an ambulatory 24–48-hour Holter or implantable loop recorder (ILR). However, nowadays non-invasive instruments, such as patches, smartwatches and smartphones based on single-lead ECGs that perform extended monitoring, are also available. The aim of this narrative review was to assess whether these instruments, when they detect arrhythmias and bradycardias in patients with adult congenital heart disease, will lead to meaningful changes in clinical care. Clinically meaningful changes include adjustment of medication, cardioversion, electrophysiology study, ablation or implantation of a cardiovascular implantable electronic device. The following monitoring instruments are discussed: cumulative Holter, 2-week continuous monitor, smartwatch- and smartphone-based single-lead ECG, and ILR. The diagnostic yield of extended rhythm monitoring is high, and varies between 18% (smartphone-based single-lead ECG) and 41% with ILR. In conclusion, contemporary arrhythmia screening includes various new non-invasive technologies that are promising new tools as an alternative to Holter monitoring or ILR. However, the optimal mode of detection is still unclear due to the lack of head-to-head comparisons.

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A comparison of ECG-based home monitoring devices in adults with CHD

Cited by 7 publications

References 28 publications

Validation of smartwatch electrocardiogram intervals in children compared to standard 12 lead electrocardiograms

Validation of smartwatch electrocardiogram intervals in children compared to standard 12 lead electrocardiograms

Smart devices to measure and monitor QT intervals

Value of Extended Arrhythmia Screening in Adult Congenital Heart Disease Patients

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